American Family Physician in 2 Minutes

The American Family Physician is a peer reviewed journal put out by the American Academy of Family Physicians about twice a month.  Although to read every word would take several hours per edition, I feel like I can make a pretty fair pass through it in about an hour.  None-the-less copies seem to accumulate on my desk as well as the desks of some of my associates, and I thought readers, family docs and others, might enjoy a very fast summary of this family doctor’s take on what’s really interesting in each edition.  So here is my first pass at AFP in 2 minutes:

AFP Volume 81 #10 May 15, 2010

Nursing Home Care: Part 1. Principles and Pitfalls of Practice.

1.5 million Americans live in nursing homes.  Another million are in assisted living.  This article is a snooze.

Nursing Home Care: Part 2: Clinical Aspects.

More interesting stuff here.  Consider liberalizing diets to avoid weight loss from poor calorie intake.  Try to avoid feeding tubes. Rarely do they lead to good outcomes. When using opioids review other meds for drug interactions, especially oversedation.  Same with drugs for urinary incontinence.  Drug adverse effects are very common, consider any new symptom a drug effect until proved otherwise.

Diagnosis and Initial Management of Acute HIV Infection: 

Tough issue here is diagnosis.  Keep up your index of suspicion, presents as 2-4 week illness with mono or influenza like symptoms.  Diagnostic test is for acute HIV infection is HIV viral RNA.  Estimated 56,300 new cases in 2006. 

Primary Care of Adult Survivors of Childhood Cancer:

About 300,000 adult survivors of childhood cancer out there.  Overall nothing startling here.  Try to have a complete summary of cancer treatment on the patient’s chart, so you can figure out what they are at risk for.

Primary Care Interventions to Promote Breast Feeding:

This boils down to do what you can to encourage women to breastfeed.  There is a some marginal data that supports the effectiveness of physician encouragement.

Delirium at the End of Life

Most people become delirious before they die.   Duh? You can skip this one. 

Febuzostat (Uloric) for Treatment of Hyperuricemia and Gout.

Nice to have an alternative to allopurinol.  Good news is it gives us an alternative in  cases of allopurinol allergy, or failure.  Bad news: expensive ($160./ month) more hepatic toxicity and although it works better, allopurinol works well enough. 

Guidelines for the Diagnosis and Management of Hoarseness:

Bottom line is if hoarseness needs evaluation, the thing to get done is visualization of the vocal cords and larynx, not a bunch of other imaging and tests.

Comments of whether anyone likes this post will be appreciated.  If you like it forward it on to your FP and primary care colleagues.

2 Responses to American Family Physician in 2 Minutes

  1. Jim, I think the Wall Street Journal does that in the two column front page section.

  2. Good 2-minute summary, but I don;t read the American Family Physician.

    You could really help me if you could do a daily 2-minute summary of the New York Times.

    Jim Purdy

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